Sunday, December 26, 2021

Remembering the Tsunami Disaster

Dr. Ruwan M Jayatunge 

The massive earthquake off the west coast of Indonesia on December 26, 2004, registered a magnitude of nine on the Richter scale. The effect of this earthquake made massive tidal waves that destroyed the coastal belt of northern and southern Sri Lanka. Perhaps this must have been the most catastrophic natural disaster ever experienced by Sri Lankans in their recent history. The damage was colossal. The tsunami had killed over 50,000 people in Sri Lanka. A number of villages have been wiped off and more than 100,000 houses were destroyed.

Post-traumatic Reactions Following Tsunami Disaster in Sri Lanka

The tsunami had damaged the physical and mental health of the survivors. The victims experienced multiple intense stressors. Injury and life threats caused psychological impairment. The magnitude of exposure to the Tsunami disaster was vastly related to the risk of psychological illnesses. The individuals with previous trauma became more vulnerable. The Tsunami disaster of 2004 generated a significant number of victims with PTSD. The research survey done by Dr. Padmini Ranasinghe (Depression and PTSD among Tsunami survivors living in transitional camps in Sri Lank) indicated that a significantly high prevalence of depression (69.2%) and PTSD (55.7%) in these displaced populations six months into the recovery, compared to estimated 10% prevalence of psychological disorders among the general population.

The Immediate effect of the Tsunami Disaster

Soon after the tidal waves, the survivors panicked, some went all over in search of their family members. The psychological problems that resulted from the Tsunami disaster include feelings of shock, fear, grief, anger, resentment, guilt, helplessness, hopelessness, and emotional numbness. Among the cognitive reactions confusion, disorientation, indecisiveness, worry, difficulty in concentrating, memory loss, and unpleasant intrusions were prominent. Loss of homes, valued possessions, livelihood, and community made many destitute among people who were self-sufficient before the disaster. The life-threatening personal experiences, loss of relatives and property have caused psychological disturbances such as acute stress reactions, PTSD, depression, and various other anxiety-related illnesses.

In December 2004, the South Asian Tsunami destroyed not only people and property but the mental happiness of the survivors. People experienced grief reactions and they were shattered by the property damage. The survivors had little salvage soon after the Tsunami. Depression was strongly related to the accumulation of post-Tsunami living conditions.

Mr. L had been a successful fisherman before the tsunami. With the disaster, he lost his house, livelihood, and personal identity as a productive member of society. Mr. L and his family members had to live in a refugee camp with minimum facilities. A few months after this unbearable catastrophe, Mr. L became depressed. His symptoms included persistent depressed or irritable mood, loss of appetite, sleep disturbance with often early-morning awakening, greatly diminished interest in life activities, fatigue, and loss of energy, feelings of worthlessness, feelings of hopelessness, and sometimes thoughts about suicide.

Mr. U was a soldier who had come home from work that morning and was enjoying a cup of tea. When he heard people screaming, he went out and saw a large wave coming toward his house. He immediately went to rescue his sister and her children. As the waves came, he grabbed the sister and her two children. He was able to hold onto his sister but two girls were taken by the waves. They were never able to find their bodies. Mr. U became extremely sad and started blaming himself for not rescuing the two little girls. His grief reactions were often evoked by reminders. His depressive reactions became quite serious, leading to traumatic grief.

His initial reaction was disbelief and disassociation. He thought that the children would be found alive. After the sea became calm, he started searching for them. He saw a large number of dead people. Among the dead bodies, there were children. Gradually be became frantic and started screaming and searching for them. But he did not see them. Mr. U even went to Matara Hospital in search of his sister's little children. He blamed himself for not serving the lives of two girl children.

Tsunami Related PTSD

The Tsunami had a direct effect on the mental health of the survivors. A large number of people developed PTSD as a result of Tsunami related catastrophic events. The victims often relived the experience through intrusions, nightmares, and flashbacks. They become less responsive emotionally depressed, withdrawn, and more detached from their feelings. Many victims received counseling and psychosocial support from various organizations. A number of clinics were opened in the affected areas. Although the rate of PTSD in children and PTSD symptoms in adults decreased over time some individuals, still experience posttraumatic symptoms even many years after this natural catastrophe.

The International Post-Tsunami Study Group examined psychological symptoms experienced by people from the Peraliya area (a district in the southern province of Sri Lanka) 20 to 21 months after the tsunami and found that 21% had PTSD, 16% had severe depression, 30% had severe anxiety and 22% had somatic symptoms.

The degree of exposure to a disaster determines the risk and level of psychological morbidity. Professor Edna B. Foa of the University of Pennsylvania accentuates that most affected individuals recover with time. In some cases, however, recovery is incomplete, leading to a number of psychiatric conditions, of which PTSD is the most frequently encountered. PTSD often coexists with a variety of psychiatric and physical disorders, which further increase the burden of suffering experienced by the patient.

Time does not heal the trauma

Recent reports suggest that after natural disasters mental health problems can emerge in vulnerable groups. The tsunami caused people to grieve. Overloaded dysfunctional grief process affected the victims to a significant level and their posttraumatic symptoms did not diminish for a long time. Some victims still carry the horrific memories of the 2004 Tsunami Disaster. Mr. Nx4 is one of them.

When the Tsunami wave-washed, the Southern coast of Sri Lanka Mr. Nx4 was in Colombo. When he heard the calamity, he rushed to his house in Matara. Since the transportation was crippled, he took much effort to come home. When he came home he did not see his house, he saw the broken walls and the foundation of the house. When the disaster occurred, his pregnant wife and seven-year-old son were in the house.

He went in search of his family. Eventually, he found the body of his pregnant wife and the child among the dead bodies. He was utterly devastated and could not overcome the emotional soreness.

After the funeral, he went to live with his uncle and had no aim in life. Two months after the disaster he tried to commit suicide by hanging. Then he was hospitalized and later diagnosed with PTSD. He was treated with Electro Convulsive Therapy. Although he was on long-term therapy Mr Nx4 experienced posttraumatic symptoms to a considerable degree. When he was clinically, re assessed 3 years after the Tsunami disaster it was found that Mr. Nx4 still had nightmares, intrusions, suicidal ideation, emotional numbing, and many other PTSD symptoms.

Addiction related behavior

Disasters generally have other long-term mental health consequences, functional disabilities, and disorders associated with substance abuse. Posttraumatic stress disorder may be a risk factor for nicotine and drug use disorders (Breslau N, Davis GC, Schultz LR: Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma). Many psychological victims of the Tsunami disaster continue to exhibit addiction-related behavior. Increases in alcohol, cannabis and tobacco use were significantly increased following the trauma especially among the males.

Mr. DX5 lost several family members and most of his property in the Tsunami disaster in 2004 was diagnosed with PTSD in 2005. He gradually lost the will to perform day-to-day activities and started abusing alcohol daily basis. His progressive alcohol addiction caused Cirrhosis of the liver.

Mr. TX2 lost his parents and the ancestral house in Southern Sri Lanka as a result of the 2004 Tsunami, manifested intrusive memories of the gigantic wave and the dead bodies; feelings of intense distress when reminded of the trauma became more and more alienated. He constantly abused alcohol and in 2006, he was diagnosed with Alcohol Dependence.

Effects on Social well-being

Social wellbeing is a sense of involvement with the community and about being actively engaged with life. The tsunami disaster continued to have a devastating impact on the social well-being of the victims. It’s a known factor that disasters threaten personal safety, overwhelm defense mechanisms, and disrupt community and family structures. The people who were exposed to the Tsunami disaster 2004 experienced numerous psychosocial problems. Property loss, death of close relations, problems of temporary and permanent housing, poor income generation, insecurity, and uncertainty about the future made grave impacts on social wellbeing.

The impact of community losses on the psychological well-being of individuals appears to differ from that of personal losses, in that community destruction is more closely correlated with decreasing positive influences, whereas personal losses are associated with increasing negative effects. (Norris FH, Friedman MJ, Watson PJ, et al.)

Emotional well-being after Trauma

Emotional well-being depends on a nurturing environment that ensures consistent basic material and emotional necessities. Natural or man-made disasters can cause terrible personal loss, injuries and illness, and loss of vital resources. While the survivors of such tragedies may recover from their physical injuries, the emotional damage may be permanent. ( Brian Trappler – Recovering from Trauma )

Dr. Pynoos studied the effect on 231 children from three cities at increasing distances from the devastating earthquake that occurred in Armenia in 1988. Following 18 months of the event, children suffered frequently from “severe post-traumatic stress reaction” correlating with the proximity to the quake epicenter (The British Journal of Psychiatry 163: 1993).

The psychological impact of the Tsunami disaster can last for long years. Many pieces of research specify that the victims of PTSD after a natural disaster can suffer for long years. A 14-year follow-up on survivors of the 1972 Buffalo Creek flood showed a 28% prevalence of PTSD. (Green, Am J Orthopsychiatry, 1990)

James F Phifer and Fran H. Norris interviewed more than 200 older adults both before and after two distinct floods that occurred in southeastern Kentucky in 1981 and 1984. Exposure to these incidents, which differed in overall intensity, was assessed at both the individual and community levels. Based on their findings personal loss was associated with short-term increases in negative affect, limited to one-year post flood. Longer-term effects were more dependent on the level of community destruction. Exposure to high levels of community destruction was related to decreased positive affect up to two years post-disaster, whereas exposure to high levels of both community destruction and personal loss was predictive of increased negative affect for two years.

Suicides after natural disasters

The effect of the 2004 tsunami on suicide rates in Sri Lanka were done by Dr. Asiri Rodrigo and Jonathan Pimm, Consultant Psychiatrist of the Department of Mental Health Sciences, University College London Medical School, London. To investigate the effect of the 2004 tsunami on suicide rates in Sri Lanka the number of suicides in the 2 years prior to and 1 year after the tsunami were considered for the study. Data from districts affected by the tsunami were compared with those from unaffected districts. They found that no significant differences were found between the number of suicides before and following the disaster or between areas affected and unaffected by the tsunami.

Krug EG. Krensnow and his colleagues of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA conducted a study on suicide rates after natural disasters. From a list of all the events declared by the U.S. government to be federal disasters between 1982 and 1989, they selected the 377 counties that had each been affected by a single natural disaster during that period. They collected data on suicides during the 36 months before and the 48 months after the disaster and aligned the data around the month of the disaster. Pooled rates were calculated according to the type of disaster. Comparisons were made between the suicide rates before and those after disasters in the affected counties and in the entire United States.

Krug EG. Krensnow is on the view that among the victims of floods, earthquakes, and hurricanes, there is an increased prevalence of post-traumatic stress disorder and depression, which are risk factors for suicidal thinking. Their findings indicate that natural disasters would increase psychological morbidity and suicide rates.

Krensnow and his colleagues found that that suicide rates increase after natural disasters like severe earthquakes, floods, and hurricanes. The increases in suicide rates were found for both sexes and for all age groups. Based on the results they confirm the need for mental health support after severe disasters.

The Tsunami Victim kills her three-year-old son

A 30-year-old mother who was exposed to Tsunami disaster in 2004 residing at the tsunami housing scheme in Panadura alleged to have thrown her three-year-old youngest son to the Kalu Ganga. The incident occurred in 2010 March over 5 years after the initial traumatic experience. Her husband had abandoned her and she had faced utmost difficulties in taking care of her five children. The child was thrown into the river due to dire poverty and lack of social support. On the day, the child was thrown to the river the mother had tried to hand over the child to a children’s home but the authorities had turned down her request.

Post Tsunami Rehabilitation Work in Sri Lanka

Post Tsunami mental health rehabilitation work took place soon after the disaster. Renowned mental health professionals like Professor William Yule, Professor Rachel Tribe, and many others offered their services to Sri Lanka to upgrade mental health services. Dr. Neil J Fernando – Consultant Psychiatrist conducted mobile mental health clinics treating a large number of victims who were shattered by the natural disaster. Dr. Neil Fernando also took a praiseworthy initiative to train counselors and social service workers in Tsunami affected areas.

The EMDR-Humanitarian Assistance Programs (HAP) whose mission is to build capacity for effective treatment of traumatic stress disorders in underserved communities anywhere in the world gave their utmost support to Sri Lanka for the post Tsunami rehabilitation work. On the directions and guidance of Dr. Francine Shapiro - the creator of EMDR, a team of specialists came to Sri Lanka to assist the local therapists. Dr. Nancy Errebo and her EMDR HAP team closely worked with the local doctors and helped to treat the victims of the 2004 Tsunami.

Although mental health treatment programs went effectively, psychosocial promotional activity did not go hand in hand. Sri Lanka received over US$2.2 billion (euro1.74 billion), as post-tsunami foreign aid. Unfortunately, large amounts of funds were not spent effectively and nearly 500 million USD provided by the foreign donors for tsunami reconstruction has gone missing. Only a small percentage of aid reached the intended recipient. After ten years of the tsunami disaster, some survivors still live in new settlements lacking basic facilities.

The reverberation of the 2004 Tsunami is still harrying Sri Lankan society. In 2010 March, a former tsunami victim had thrown her 3-year-old son to the Kalu Ganga River. If this family that was displaced by the 2004 tsunami had appropriate psychosocial support, this tragedy could have been evaded.

ලිංගයට වඳින ගාථාව


වන්දාමි ලිංගම්
ක්‍ෂීර ධාතු සේවනා
අහේතුකං විචාර බුද්ධිං
ආමිසෝ පුරුසං නිමිත්තං

Sunday, December 19, 2021

බණ්ඩාරනායක, ගුණදාස අමරසේකර , නලීන් සිල්වා සහ කවුන්ට කල්චර් එකේ සන්නස්ගල

අපිට සංස්කෘතික වශයෙන් ධර්මපාල , බණ්ඩාරනායක, මෙත්තානන්ද , ගුණදාස අමරසේකර , නලීන් සිල්වා මොනවද දුන්නේ ?. ඔවුන් අපව සංස්කෘතික පසුගාමීත්වයේ හිර කරන්න ෆුල් ට්රයි එක දුන්නා. අද ගොවිඳුලා කරන්නෙත් මේකමයි.

බණ්ඩාරනායක, ගුණදාස අමරසේකර , නලීන් සිල්වා ලෝකයෝ. ඔවුන් තමන් ගේ ලමයින් ඒ පසුගාමීත්වයෙන් මුදා ගත්තා. ඔවුන් ගේ ලමයි බටහිරත් එක්ක සාර්ථකව සංස්කෘතික වශයෙන් ගනුදෙනු කරනවා.

අද ලංකාවේ කවුන්ට කල්චර් එකේ ඉදිරියෙන්ම ඉන්නේ සන්නස්ගල වගේ අය. සන්නස්ගල ගෙන් අහන්න Ian Sutherland , Maria Callas , Rudolph Valentino , Martin Sheen , George Benson යන අය කවුද කියලා ඔහු දන්නේ නෑ. ඒක සන්නස්ගල ගේ වැරැද්ද නෙවෙයි. හේතුව මේ ධර්මපාල , බණ්ඩාරනායක, මෙත්තානන්ද , ගුණදාස අමරසේකර , නලීන් සිල්වා සෙට් එක සන්නස්ගල ලාගේ පරම්පරාවට ඒ දැණුම ගලා එන එක වැලැක්කුවා. නමුත් අනුර බණ්ඩාරනායක ගෙන් අහන්න Ian Sutherland , Maria Callas , Rudolph Valentino , Martin Sheen , George Benson යන අය කවුද කියලා. ඔහු ඒ අය දැනගෙන සිටියා. සංස්කෘතිකව අනුර බණ්ඩාරනායකලා වගේ අය අප්ඩේට් වෙලා හිටියේ.

ලංකාව අන්තර්ජාතික සංකෘතික ලෝකයට යා කරන්න ඉහල මධ්‍යම පාන්තික ක්‍රිස්තියානීන් කල සේවය තියෙන්නේ තවමත් සැඟවිලා. ඔවුන් නිසා තමයි ලංකාව Jim Reeves, Elvis, Hank Snow වගේ චරිත ගැන දැන ගන්නේ. එහෙත් ඉහල මධ්‍යම පාන්තික බෞද්ධයන් වූ ගුණදාස අමරසේකර , නලීන් සිල්වා ලංකා සමාජයට බෙදුවේ සංකෘතික පසුගාමීත්වය​. මේ ටොපිය කාපු ශ්‍රී ලාංකික විශේශයෙන් සිංහල තරුණ තරුණියෝ බටහිර සමාජය එක්ක කනෙක්ට් වෙන්න යන්නේ ගංජා, අයිස් හරහා. ඒත් ඔවුන් ගේ මොලය හිස්. කඳ විතරක් ඩෙනිම් එකකින් වැහිලා.

Monday, December 13, 2021

දියසෙන් කුමරා එන තෙක්

ගෝටා බලයට එන විට ඔහු විසින් විශාල ධනාත්මක වෙනසක් ලංකාවට කරනු ඇතැයි බොහෝ දෙනෙකු බලාපොරොත්තු වූහ​. එහෙත් කෝවිඩ් සහ අනෙකුත් අභියෝග හමුවේ ඔහු ෆේල් කියා බොහෝ දෙනෙකු  ප්‍රසිද්ධියේම පවසති. මේ අනුව මීලඟ අභියෝගය භාර ගත හැක්කේ සජිත්ටද​? එහෙත් සජිත් යනු ජෝකර් කෙනෙකු බව පසුගිය කාලය පුරාම ඔහුගේම පාක්‍ෂිකයෝ පවසති. 

මේ අර්බුධ අතර ජවිපෙ අනුර කුමාර දිසානායක ගේ ජනප්‍රියත්වය වැඩි වෙමින් පවතී. අනුර කුමාර දිසානායකට ලංකාව ගොඩ ගත හැකිද ? අනුර කුමාර දිසානායක දක්‍ෂ කථිකයෙකි. රෝහණ විජේවීරට වඩා ඔහු බුද්ධිත්මත් ය​. අනුර කුමාර දිසානායක මේ දක්වා රාජ්‍ය දේපළ හොරකම් කොට නැත​. එහෙත් පුද්ගලික සමාගම් වලින් ඔවුන් කප්පම් ගන්නවා යන කතාවක්ද පවතින බවද කිව යුතුය.  

අනුර කුමාර දිසානායක බලයට ආවහොත් හොරකම , දූෂණය තාවකාලිකව අඩු වනු ඇත​. එහෙත් විදෙස් ශ්‍රමිකයන් ගෙන් $ 500 ගනනේ ඉල්ලනවා හැර වෙනත් ප්‍රායෝගික විසඳුමක් ඔහු සඳහන් කරන්නේ නැත​. තවද දිය ලනුවත්  අනුන් ගෙන් ඉල්ලා ගෙන අඳින හඳුන්නෙත්ති වැනි නායකයන්ට අනාගත ලෝකයට ගැලපෙන ආර්ථික දර්ශනයක් තිබෙනවාද ?   මේ අනුව ලංකාව තව දුරටත් ප්‍රපාතයට යනවා මිස බලාපොරොත්තුවක් තබා ගැනීම අසීරුය​. මේ නිසා දියසෙන් කුමරා එන තෙක් සිටිය යුතුය. 

Monday, November 29, 2021

අයියා පුතා සහ බම්බලපිටියේ මිනිසා මුහුදට පළවා හැර මරා දැමීම

බම්බලපිටියේ මිනිසා මුහුදට පළවා හැර මරා දැමීම පිලිබඳව 2009 වසරේදී මා විසින් Daily News පුවත් පතට ලිපියක් ලිව්වා. මේ ලින්ක් එකෙන් එය කියවිය හැක. 

අයියා පුතා

This is what we have become 

On October 29, 2009 a man was throwing stones at trains and vehicles passing Bambalapitiya, Colombo 4. Angry crowds reported this incident to police and a constable from the Bambalapitiya police station came to the scene immediately. Instead of using his intellect and skills, the constable started beating him and the fearful man jumped into the sea.   Seashore tragedy … It is unfortunate that onlookers failed to save the man from drowning  The constable reportedly took a wooden pole and with the help of another two men started assaulting the victim. The helpless man brought his hands together and worshipped his tormentors. But they did not stop. They continued to beat him until he drowned. When this incident occurred, more than 100 people were watching it and no one spoke against it or intervened to save the man.  

The victim was later identified as B. Sivakumar (26), a resident of Ratmalana.  He was also a psychiatric patient who had taken treatment from the Angoda Mental Hospital. Probably, he suffered from Schizophrenia, and following auditory hallucinations, he started throwing stones at vehicles, or maybe he had BPAD (Bipolar Affective Disorder) in his manic phase and became aggressive and reactive. Sudden provocation could have led him to throw stones at vehicles. Apart from the illness, the 30-year armed conflict in Sri Lanka may have aggravated his mental health.  

At a time like this when racial tension has reached its maximum levels, one can come to a petty and racial conclusion that a Sinhalese Police officer killed a Tamil man in the heart of Colombo in broad daylight. Most probably, the people did not know the man's nationality when they first saw him throwing stones. Of course, they were mad at him.  Also, they knew that he was doing an abnormal thing. But no one wanted to calm him down or not provoke him further. This indicates the most pathetic part of the incident. People encouraged the tormentors with their non-interfering attitude and silence. In a war-torn society, this silence and emotional apathy represent a social dilemma and retraumatization. This has become a damaging feature that is prevailing in contemporary Sri Lankan society. People mind their own business saying that "we are good citizens, we don't want to get involved".  That is the common attitude of the intellectuals, artists, etc. This condition is expressed by one of my good friends as "fear" overrides a sense of humanity. On October 29, 2009, at Bambalapitiya seashore, we witnessed this condition again.  In Medieval Europe, psychiatric patients were regarded as the agents of Satan and they were tortured and often burnt to death.

The humane way of treating psychiatric patients in Europe started with Dr. Philippe Pinels reformations in the 18th century.  But 2,500 years ago, we Sri Lankans treated psychiatric patients with compassion. Kohombakankariya, which is an ancient Sri Lankan ritual and a mode of psychotherapy, testifies that we did not burn psychiatric patients but cured them. King Buddhadasa (340-368 A.D.) was a magnificent physician as well as a psychotherapist.  One day, a man insulted and humiliated the king in public. Instead of sending him to prison, the king did a psychological profile on him and came to know that the man was mentally unsound.  King Buddhadasa treated the patient and the man regained his insight. As the story goes, he became a good friend of the king. There are reports from all over the world that psychiatric patients are mistreated and face discrimination.  

 Many law and enforcement officers have no idea about the trauma/psychiatric-based behavior of a mentally unsound man.  The Bambalapitiya incident reflects this once again. Many psychiatric patients do not seek treatment following social stigma.  In Sri Lanka, there are a large number of people (civilians/military/ex-militants) with untreated and undiagnosed malignant PTSD. These men can go into tantrums or flashbacks with a sudden provocation or with arousal.  How are we going to deal with this in the future? Are we going to repeat the Bambalapitiya incident again?

Monday, November 15, 2021

VOG ඇන්දීම

1997 කාලයේ මම මීගමුව දිස්ත්‍රික් රෝහලේ ජේෂ්ඨ වෛද්‍ය නිලධාරී - නාරි හා ප්‍රසව ( SHO Gyn and OBS) ලෙස සේවය කලෙමි. මාගේ විශේසඥ වෛද්‍යවරයා වූයේ VOG අජිත් සේමසිංහ මහතාය. ඒ කාලයේ සතියට දින 6 ක් නයිට් ඩියුටි කිරීමට මට පැවරී තිබුනි.

එක් දිනක් සවස 7 පමණ ලේබර් රූම් එකේ සිටියේ එක්ම එක් මවකි. ඇය පරික්‍ෂා කල විට (OS) සෙන්ටිමීටර් 4 පමණව තිබුනි. එසේම එතරම් ප්‍රසව වේදනාවද නැත. වාට්ටු දෙකම සන්සුන් ය. ලේබර් රූම් එකේ සිටියේ ගුණපාල මිස්‍ ය. ඇය අත්දැකීම් බහුල හෙදියකි. මේ නිසා බිය වීමට දෙයක් තිබුනේ නැත.

සවස 7.45 වන තෙක් වාට්ටුවල කරක් ගසා මම රාත්‍රී ආහාරය සඳහා යන බව ගුණපාල මිස්‍ට කියා නිල නිවාසය දෙසට ගියෙමි. රාත්‍රී කෑම සඳහා බොහෝ විට අප ගියේ රෝහල ඉදිරිපිට ඇති හොටෙල් ඩී බඩසුද්ද නම් හෝටලයටය. ඒ කාලයේ අප නිතරම කෑවේ කොත්තුය. මේ නිසා නිවසට ගොස් හෝම් කුක්ඩ් ආහාර වේලක අවශ්‍යතාව දැනුනි.

ඒ කාලයේ මා සිටියේ කඳානේය. වාට්ටුවේද ගින්නක් නැත. ඒ නිසා මම මාගේ වාහනයේ නැගී මීගමුවේ සිට කඳානට වේගයෙන් ගියෙමි. ගෙදර ගොස් බත් කටවල් දෙකක් වත් කෑමට ඉඩ නොලැබුනි. මාගේ සෙල් එකට විශේසඥ වෛද්‍ය සේමසිංහ මහතා ගෙන් කෝල් එකක් ආවේය.

" රුවන් කොහොමද ලේබර් රූම් එක ? සර් ඇසුවේය. මම ඉක්මනින් කට සෝදාගෙන "සර් මොකුත් ප්‍රශ්නයක් නෑ එක ලෙඩයි ඉන්නේ" කියා කීවෙමි. දැන් කෝච්චරක් ඩයිලේට් වෙලාද ? කියා වෛද්‍ය සේමසිංහ මහතා ඇසුවේය. දැන් කේස් ය. මා ඉන්නේ කඳානේ කියා සර්ට කිව නොහැක. "මම ඉන්න සර්" කියා සෙල් එක පැත්තකින් තියා තව බත් කටවල් දෙකක් ඉක්මනින් කා , කට සෝදාගෙන සර් ෆයිව් සෙන්ටිමීටර් වගේ තියෙන්නේ එච්චර පේන් එකකුත් නෑ මම ASM.කරන්නද ? කියා ඇසුවෙමි ( දැන් මම රඟපාන්නේ මා සිටින්නේ ලේබර් රූම් එකේ ඉන්න ලෙසටය).

අජිත් සේමසිංහ මහතා මොහොතක් කල්පනා කොට " පොඩ්ඩක් ගුනපාල මිස්ට කතා කරන්න " කියා කීවේය. දැන් මට ඇපත් නැත. මම වහාම දුරකතනය විසන් දි කොට පවනට බඳු වේගයෙන් මීගමුව රෝහලට ගියෙමි. ලෙඩා තවමත් ලේබර් රූම් එකේය. තත්වය සන්සුන් ය.

පසු දින VOG අජිත් සේමසිංහ මහතා වෝඩ් රවුන්ඩ් එන විට මගේ රඟපෑමට ඩෝස් එකක් ලැබෙන බව මගේ සිත කීවේය. එහෙත් අජිත් සේමසිංහ මහතා කිසිවක් නොකියා වෝඩ් රවුන්ඩ් එක කලේය. මා කට්ටි පැන්න බව එතුමා හොඳින්ම දැන සිටියද කේස් එකක් ඇද්දේ නැත.

විශේසඥ වෛද්‍ය අජිත් සේමසිංහ මහතා මට හමුවූ වෛද්‍යවරුන් ගෙන් ඉතා දක්‍ෂ මෙන්ම මානුෂික ගති තිබූ වෛද්‍යවරයෙකි. නිහතමානී පුද්ගලයෙකු වූ එතුමා අපට අනවශ්‍ය ලෙස පීඩනයක් දැම්මේ නැත. එතුමා සමග සේවය කිරීමට ලැබීම ජීවිතයේ ලැබූ අනගි අත් දැකීමකි. ආතතියට පත් නොවී සීසර් වැනි ශල්‍යකර්ම කිරීම මා ඉගන ගත්තේ එතුමාගෙනි.

එතුමා මගේ මුහුණු පොතේ සිටින අතර මේ සටහන කියවනු නිසැකය. ඒ නිසා 1997 වැනි කාලයක එතුමාව ඇන්දීමට තැත් කිරීම ගැන මා සමාව අයදිමි

Saturday, November 13, 2021

පීඩිතයෝ විසින් බඩට කිස් දීම

බඩට කිස් දෙන කොට මාර කිතියක් දැනෙනවා. සමහර වෙලාවට ශර්ට් එක අස්සෙන්  ශේව් නොකරපු නිසා බුවාලාගේ රැවුල් කෑලි ඇනෙනවා. පීඩිත බුවාලාගෙන් බඩට කිස් එකක් ලැබෙනවා කියන්නේ උපරිම භක්තිය. මේ   බඩට කිස් දෙන එක ගැන ලියපු ලිපියක් :

Sunday, October 31, 2021

I read Dr. Ruwan M Jayatunge's "වෛද්‍යවරයෙකුගේ සිහි සටහන්" with great enthusiasm- Dr. Chandani Galwaduge

I read Dr. Ruwan M Jayatunge's "වෛද්‍යවරයෙකුගේ සිහි සටහන්" with great enthusiasm. Dr. Ruwan joined Kandy district preventive health team in 1996 as the MOH Minipe. At that time I was the MO (MCH ) in Kandy district. It was difficult to ignore this charismatic young doctor who always was with a smiling face. Very enthusiastic young doctor; participated in the district monthly MOH review meetings without fail despite the distance and the difficult road that he had to travel.  Lively participated in all our discussions and was excellent in monitoring MCH activities within his area including all maternal deaths... That was the time Sri Lanka conducted National Immunization Days to eradicate Polio. During these Ruwan exhibited his ability to coordinate with Government and non Governmental organizations and achieved 100% coverage...Even during those young days, he demonstrated all the signs of success late in his life.                                                                                                                                       

Dr.  Chandani Galwaduge -  Former Consultant Community Physician, Central Province    



Thursday, October 28, 2021

ELASTO සහ දහම්සොඞ ජාතකය

මෙතන 1970 ගනන් වල මැද වෙසක් එකට තොරණක් තිබ්බා. ඒ තොරනේ තිබ්බේ  දහම්සොඞ රජ  රාක්‍ෂයාගේ කටට පර්වතයක් උඩින්  පනින කතාව. යකෙක් හදලා පර්වතය උඩ ඉඳන් රජතුමා පනින එක යන්ත්‍රානුසාරයෙන් පෙන්වනවා. මමයි මල්ලියි මේක බලන්න ගිහින් තිබූ කුතුහලය නිසා  තොරණ කවර් කොට තිබූ ඉටි කොලයක් ඉස්සුවා, එතකොට අපි දැක්කා සරං කාරයෙක් දාඩිය දාගෙන බයිසිකල් චේන් වලින් හදපු යන්ත්‍රයක් කරකවනවා. අපි ඉටි කොලය උස්සලා පොරව එක්ස්පෝස් කරපු නිසා මෑන්ට කේන්ති ගොස්   මට කිව්වා"දුප්   කැ... කියලා , මම එතකොට 7 වසරේ විතර​. බය වෙලා අපි මිලාගිරිය සෙන්ට් පෝල්ස් එක ලඟට වෙනකම් දිව්වා.  

Saturday, October 23, 2021

බංකර කුරුටු ගී එකතු කල යුද හමුදා නිලධාරියා


මේජර් කමල් ශ්‍රී මනතුංග  උතුරු යුද පෙරමුණු වල සොල්දාදුවන් විසින් ලියන ලද කුරුටු ගී එකතු කොට ඒවා අනාගත පරපුර සඳහා සංරක්‍ෂණය කල නිලධාරියෙකි. ඔහු මට කොලඹ යුද හමුදා රෝහලේදී 2004 වැනි කාලයක හමු විය​. යුද ආතතියට ලක් වෙමින් සතුරු වෙඩි ප්‍රහාර මධ්‍යයේ සේවය කල සොල්දාදුවන් තම දුක , තනිකම සහ හිතේ පීඩනය පහ කර ගැනීම සඳහා බංකර් වල ලියන ලද කුරුටු ගී එකතු කරමින් සිටින බව ඔහු මට කීවේය​. වරක් සතුරු ඉසව්වක තිබූ අත් හැර දමන ලද බංකරයක ලියන ලද  කුරුටු ගීයක් පිටපත් කර ගැනීම සඳහා ගිය අවදානම් සහිත ගමනක් පිලිබඳවද ඔහු මට හෙළි කලේය​. මා විසින් ලියන ලද සංග්‍රාමයෙන් පසු (සරසවි ප්‍රකාශකයෝ)  ග්‍රන්ථයේද  මේජර් කමල් ශ්‍රී මනතුංග  මහතා විසින් මට ලබා දුන් කුරුටු ගී කීපයක් සඳහන් වෙයි. අවාසනාවකට මෙන් මේජර් කමල් ශ්‍රී මනතුංග මීට වසර කීපයකට ඉහතදී රෝගාතුරව මිය ගියේය​. එහෙත් ඔහු විසින් එළි දක්වන ලද ඊලාම් යුද්ධයේදී සොල්දාදුවන් විසින් ලියන ලද කුරුටු ගී කෘතිය අනාගත  පරියේෂකයන්ට වැදගත් වනු නොඅනුමානය​. 

Monday, October 18, 2021

වෛද්‍යවරයෙකුගේ සිහි සටහන් අනගි කෘතියක් - විශේසඥ වෛද්‍ය ආර්.එන්.ජී රාජපක්‍ෂ


වෛද්‍ය විද්‍යාවේ විවිධ ක්ෂේත්‍ර ගැන පලපුරුද්ද ,හැකියාව සහ අත්දැකීම් ඇති වෛද්‍යවරුන් අදදින සොයාගැනීම විරලය. මන්ද මූලික උපාධිය ලැබූ විගස නගරය ආශ්‍රිතව රැඳී සිටිමින්, යම් විශේෂ ක්ෂේත්‍රයකට සීමාවී එතැන් පටන් විශේෂඥ දැනුම ලබා ගෙන ඉක්මණින්ම වෘත්තිය තත්වයකට එළඹීමට බොහෝ වෛද්‍යවරුන් උත්සාහ කිරීම නිසාය.

වෛද්ය රුවන් ජයතුංග ගැන මා තුල ඇති ආකල්පය ඊට වෙනස්ය. මූලික උපාධියෙන් පසුව දුර බැහැර රෝහල්වල රැඳී සිටිමින්, විවිධ ක්ෂෙත්ර වල අත්දැකීම් ලබමින්, ඒවායේ හදවතින්ම සේවය ලබාදෙමින් ඔහු අත්දැකීම් සම්භාරයක් ලබාගත් බව මම නිසැකවම දනිමි.

ප්රසව හා නාරිවේද විශේෂඥ වරයෙකු ලෙස 1999 -2002 වසරවල මා සමග හලාවත මහ රෝහලේ සේවය කිරීමේදී ඔහු මාගේ සැත්කම් වලට නිර්වින්දන වෛද්ය වරයෙකු ලෙස සේවය ලබා දුන් කාලයේ මම එය හොඳින් අවබෝධ කර ගතිමි. තම සේවය උපරිම ලෙස ලබා දී රෝගියා ගැන මනා සැලකිල්ලකින් කටයුතු කිරීම මා දුටු ඔහුගේ විශේෂ ගුණාංගයකි.

සිය ගණනක් වෛද්යවරුන් මා අතින් පුහුණුව ලැබීය. වෛද්ය රුවන් මාගේ ක්ෂේත්රය තුල නොසිටියත් ඔහු කවදා හෝ රෝගීන්ට අත්යාවශ්ය ,දීප්තිමත් වෛද්ය වරයෙකු වන බව මම එදා ඔහුට අනාවැකියක් පැවසුවෙමි. අද එය ඉටුවී ඇති බව දැකීම සතුටකි.

අද මනෝවෛද්ය ක්ෂේත්රය තුල විවිධාකාරව සේවය ලබා දුන්නත් විවිධාකාර අත්දැකීම් සම්භාරයක් ලබා එම ක්ෂේත්රයේ පොත් රාශියක් ලියා ,තම අත්දැකීම් ගැන මෙවැනි පොතක්ද ලියූ ඔහු ගැන හැඳින්වීමක් ලිවීමට මා හටද අවස්ථාවක් ලැබීම සතුටකි.

වෛද්ය ආර්.එන්.ජී රාජපක්ෂ.
ප්රසව හා නාරිවේද විශේෂඥ.

Friday, October 15, 2021

The Terror Management Theory and the Movie Bambara Walalla


Dr. Ruwan M Jayatunge

Man is constantly building the “Image.” It is an Edifice for the entombment of bones –Irvin Kauffman

 Sri Lankan film director Athula Liyanage’s award-winning movie Bambara Walalla discusses an uncommon topic that has close connections with the futile human existence and death. The movie Bambara Walalla unveils the unsophisticated reality of existence and death in the rural underworld in Sri Lankan society. Athula Liyanage pontificates the unfounded and senseless existence of a man who is persecuted by life’s miseries through his movie.

The existence and meaning of life constitute a philosophical question and some believe that human life is mostly a dream, from which people never really awake. Meaning in life varies from person to person, depending on each one’s variable mental state. Bambara Walalla echoes that in a world filled with chaos and suffering human existence becomes absolutely hollow.

 The Main Characters of the Movie

Mel Mahaththaya (Mr. Mel) and Gonamdithhe Podi Eka (the little fellow) are the protagonists of this film around whom the events of the narrative’s plot revolve. The movie Bambara Walalla could be classified as a gangster movie that has touched the imperceptible mob rules in Sri Lankan rural communities.

 As Lee Horsley once stated the mythologized gangster can only be understood in relation to the wider society, whether he is cast as a villain whose actions confirm the need for law and order or as an outlaw hero admired for the toughness and energy with which he defies the system. Lee Horsley’s edict is mostly applicable to Bambara Walalla .

There are no heroes or archetypal heroes in BambaraWalalla. The two main characters – Mel Mahaththaya (Mr. Mel) and Gonamadithhe Podi Eka (the little fellow) represent the rudiments of the rural underworld that is prevailing in modern Sri Lanka. Both characters are complex in nature. Mr. Mel is a kindhearted businessman (an undertaker) who is ready to help anyone in need. But in-depth there is an alligator inside him. Although Mr. Mel accommodates people he always expects something profitable in return. Mel is driven by power, ulterior motives and he is ready to commit murders if anyone obstructs his path. Podi Eka or the little fellow blindly follows Mel’s orders until he realizes that Mel is a mean character like his uncle who raped his sister and brought irreversible misery to his family.

 Bambara Walalla And the mortality Salience

Mortality Salience is vastly associated with the movie Bambara Walalla. The Social Psychologist Jeff Greenberg hypothesized human behavior is motivated by the fear of mortality. In 1986 with his colleagues Jeff Greenberg introduced a new theory named Terror Management Theory (TMT) that concerns the psychological consequences of the juxtaposition of a biologically rooted desire for a life with the awareness of the inevitability of death.

 Mr. Mel is an undertaker and his world is surrounded by the symbols of death.

Although he sees death and dying on an everyday basis, unconsciously he de-cognizes these mortality-related indicators. Instead, he embraces life deeply, even committing murders.  He is a soft-spoken man with snake eyes and strikes unexpectedly and callously.

Ernest Becker (1973) stated that humans, unlike other animals, have the cognitive capabilities to realize that they will die, which causes deep anxiety( Vaugh 2010). Mel phonates his motility salience anxiety in numerous expressions and in his noxious behavior patterns.

 Mr. Mel and the Existential Death Anxiety

Mr.Mel is a special kind of gangster whom we have never seen before on the silver screen. He is not like Tony Montana (Scarface) who has emotional outbursts or like Capone (Untouchables) who is driven by sadistic instincts or any other villains like John Rooney (Road to Predation) Ace Rothstein (Casino) or Cody Jarrett (White Heat). Mr. Mel is a gangster who has become deeply consumed by his double life.

 Mr. Mel is driven by death anxiety on most occasions. As Dr. Robert Langs point out existential death anxiety is the most powerful form of death anxiety and its activation is based in humans on the definitive, conscious awareness and anticipation of the inevitability of personal demise.  Death anxiety prompts people to believe in anxiety as a uniform or single entity. In Mr. Mel’s instance, he responds in a distinctive manner. These responses are both conscious and unconscious.

The anthropologist Ernest Becker argues all human action is taken to ignore or avoid the inevitability of death. The terror of absolute annihilation creates profound subconscious anxiety in people. Mr. Mel’s reaction to the death anxiety is pronounced throughout the movie. His famous expression “I bury only dead people” sometimes gives us a premonition that eventually he would bury the living too.  In fact, at the end of the movie, the audience realizes that Mel was capable of committing such acts. 

 The Hit Man PodiEka or the Little Fellow

According to the social disorganization theory, a person’s physical and social environments are primarily responsible for the behavioral choices that person makes. Gona Madithhe Podi Eka or the Little Fellow witnessed the sexual exploitation, incest, and eventually, the suicide of his sister, and these family calamities made him kill his own uncle. After the crime, he was imprisoned for long years. When he comes to his native village after serving the prison term his mother had become a mental patient following the overwhelming psychological trauma.

His world was devastated for the second time when he found his pet cow was stolen and sold to the butcher. When he finds the perpetrator he unleashes extreme violence on the thief.  The cessation of his objects of love (sister/mother and the pet cow) leads him to become emotionally numbed and he acts reflexively on Mel’s orders

 Gona Madithhe Podi Eka or the Little Fellow is illiterate and unable to express his romantic feelings to the girl that captured his heart.  When he expresses his desire, the girl discards and humiliates him. He becomes furious and cuts her hair. These events show the immaturity and the imprudent nature of the Little Fellow.

When he was beaten and banished from the village, Mr. Mel the undertaker helps him with a hidden agenda. Subsequently, the Little Fellow becomes Mr. Mel’s one of the hitmen. Gradually Gona Madithhe Padi Eka becomes a deadly character like the grim reaper with his scythe.  

The third episode of  Gona Madithhe Padi Eka or the Little Fellow”…”s life reminds us of Luca Brasi – Don Vito Corleone’s loyal assassin who was immortalized by the great novelist Mario Puzo.    Puzo describes such hitmen using these words. 

 “Man who goes around life with a sign that says ‘kill me’ painted on, this makes everyone want to kill him, but yet no one can. Eventually, this man finds someone who he doesn’t want to kill and fears that this man will be the one to kill him”.

 After the final robbery, Gona Madithhe Podi Eka or the Little Fellow had a gut feeling that he would be killed. He goes into an emotional outburst and asking from Jinne (Mr. Mel’s assistant) Please tell me Jinne who is going to kill me? Whether you or  Mel Mahatthaya? He knew that his days were numbered. His life was saved unexpectedly by Mel’s so-called son.

 Although we see a senseless and callous murderer in Gona Madithhe Podi Eka there is an immature child inside him.  Largely career criminals and psychopaths have a distinctive type of behavior that is characteristic of satisfying their emotional and psychological needs.  This “need” actually feeds the motivations of the individual to commit a crime and then relish it. But  Gona Madithhe Podi Eka became a criminal due to life circumstances. Criminal intentions were never in his blood or in his genes.

 Death Anxiety and Allegiance

 Mr. Mel. builds a criminal organization and recruits henchmen. They become loyal to him and often carry out his orders without rationally analyzing the outcome. Mel expands his business and meets new enemies. When he makes a move he is compelled to strike his opponents with deadly force and let his foes shed blood. 

Mel has a gang of murderers who are allegiance to him and fulfill his orders. Affiliation to Mel’s organization gives his followers a sense of security, a sense of belongings, and meaning of life. 

 Being an associate in Mel’s anti-social organization each member unconsciously tries to minimize their death anxiety. This rural criminal organization declares wars with other gangs killing a number of people. For the members, it is like being on a war front and dying for their leader. This is a primitive form of organization and its function explained by Greenberg in 1986.  

 The war system provides the basic motivation for primary and social organization. In so doing, it reflects on the societal level the incentives of individual human behavior. The most important of these, for social purposes, is the individual psychological rationale for allegiance to a society and its values. Allegiance requires a cause; a cause requires an enemy. (Greenberg 1986)

Mel’s gang needs enemies and they find enemies in every territory. Mel expands his business and each time he meets new rivals. The business rivalry was causing heavy damage to his criminal organization and Mel took every step to silence his opponents. Eventually, the enemy comes within the organization. When the explosion occurs from inside Mel barely has a chance to stay alive.

 The Death Anxiety Continues

As social psychologists pointed out, man has an inherent tendency for self-preservation and has cognitive capability in acknowledging life’s impermanence. He is capable of coexisting with death and makes attempts to lower his death anxiety (Olivarez 2010).

 The Little Fellow alias Gona Madithhe Podi Eka escapes his death and becomes the new leader of the criminal gang. The old Don was murdered. The family needs new leadership. Gona Madithhe Podi Ekawas is unanimously appointed as the head of the family by other members and hence he becomes the new Don.No more internal conflicts and bloodshed. Peace is prevailing within the family. Like Michael Corleone, he does not feel like wiping everyone out, just his enemies. Again they are ready to sell coffins. The entire scenario reminds us of the definition of TMT (Terror Management Theory) which follows this. 

 TMT theorists believe that an individual will be so freaked out by being reminded of his death, or mortality salience, that he will invest more belief in his worldview and resist or even attack anything perceived as a threat to his worldview.

What is the worldview of this rural criminal gang? They too have a fundamental cognitive orientation, possess ethics and values. To the outside world, they are a bunch of businessmen (undertakers). Their dark images are covered by the coffins. Outsiders only see the shows moving. They are ready to oblige their silent customers who don’t yell or curse at them.  Like the previous Don, they too say “we bury only dead people

Find Us On Facebook